Individual provider Active NPI

Amy Suzanne Doss, FNP-C

  • Family Nurse Practitioner
  • Elizabethton, TN
National Provider Identifier
1245640085
Registry record updated Jul 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
18698 Issued in TN
Practice address
1641 Highway 19E Byp
Elizabethton, TN 37643-4646
Phone
(423) 282-1480
Fax
(423) 928-1353
NPI assigned
May 1, 2014
Last updated
Jul 3, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 18698 TN Primary

Addresses

Primary practice location

1641 Highway 19E Byp
Elizabethton, TN 37643-4646

Mailing address

PO Box 4018
Johnson City, TN 37602-4018
Phone (423) 282-1480

Other practice location 1

1 Medical Park Blvd Ste 350W
Bristol, TN 37620-7471
Phone (423) 282-1480

Other identifiers 1

IdentifierTypeStateIssuer
Q006985MedicaidTN

Other names 1

  • Ms. Amy Suzanne Clark Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140905002241 TN Practitioner - Nurse Practitioner 6406074368 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ipc Pac Healthcare Services of Tennessee PCGroup PAC ID 0840587572, 74 clinicians
NV Pacs 2 LLCGroup PAC ID 0941550578, 119 clinicians

Practice addresses (Care Compare)

400 N State of Franklin Rd
Johnson City, TN 37604-6035
Phone (423) 431-6111

505 N Roan St
Johnson City, TN 37601-4740
Phone (423) 975-2000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
18698TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Southeastern Physician Services PC CurrentSince Nov 5, 2017 Accepting new patients
Ipc Pac Healthcare Services of Tennessee PC CurrentSince Nov 5, 2017 Accepting new patients
CS Pacs 3 Southeast, LLC CurrentSince Jun 18, 2024 Accepting new patients
NV Pacs 2 LLC CurrentSince Sep 15, 2021 Accepting new patients

Locations

1 Medical Park Blvd
Ste 350W
Bristol, TN 37620
Phone (423) 844-4240

2305 Chambliss Ave NW
Cleveland, TN 37311
Phone (423) 559-6000

1641 Highway 19E Byp
Elizabethton, TN 37643
Phone (423) 542-4133

880 S Mohawk Dr
Erwin, TN 37650
Phone (423) 743-7669

2511 Wesley St
Johnson City, TN 37601
Phone (423) 431-1700

400 N State of Franklin Rd
Johnson City, TN 37604
Phone (423) 431-1310

1201 Bishop St
Union City, TN 38261
Phone (423) 698-6061

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1398902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688342400000",
    "number": "1245640085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4018",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376024018",
            "telephone_number": "423-282-1480",
            "fax_number": "423-928-1353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1641 HIGHWAY 19E BYP",
            "city": "ELIZABETHTON",
            "state": "TN",
            "postal_code": "376434646",
            "telephone_number": "423-282-1480",
            "fax_number": "423-928-1353"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Medical Park Blvd Ste 350W",
            "address_purpose": "LOCATION",
            "city": "Bristol",
            "state": "TN",
            "postal_code": "376207471",
            "country_code": "US",
            "telephone_number": "423-282-1480",
            "fax_number": "423-928-1353",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DOSS",
        "first_name": "AMY",
        "middle_name": "SUZANNE",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-01",
        "last_updated": "2023-07-03",
        "certification_date": "2023-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "18698",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q006985",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMY",
            "last_name": "CLARK",
            "middle_name": "SUZANNE",
            "prefix": "MS.",
            "credential": "FNP-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Elizabethton, TN

Sources for this page

Verify at the official NPI Registry.